LOVEJOY INDEPENDENT SCHOOL DISTRICT ... - Lovejoy ISD

LOVEJOY INDEPENDENT SCHOOL DISTRICTTuition-Based Limited Open Enrollment ApplicationElementary Application Grades K-6thDirections: This form is for students who do not already live within the boundaries of the Lovejoy ISD.Please complete all necessary forms required for application. Please read guidelines carefully prior to submitting application.Student Information:Student Name: _____________________________________________________________________________Last First MiddleStudent’s Home Address:_____________________________________________________________________Street_________________________ _____________ ____________City State ZIP CodeGender: □ Male □ FemaleStudent Date of Birth :______________(mm/dd/year)Is student in any special academic programs? □ Yes □ NoIf “yes,” please explain:______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Is student in any extra-curricular/athletic programs? □ Yes □ NoIf “yes,” please explain:______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Student’s Grade Level for 2013-2014:__________School where student currently attends: _____________________________________________________________________________________________________________________________________Name Address City State ZIP CodeName of School student attended in the 2012-2013 school year: ______________________________________Campus requested in Lovejoy ISD:_____________________________________________________________(Note: Campus assignment will be based on campus enrollment, grade level capacity, and program capacity.Campus assignment will be made by the Superintendent or designee and may not be appealed.)

Parent Information:Name and Address of Parent/Guardian_________________________________________________________________________________________Last First Middle Address City State ZIP CodeParent Home Phone: ____________________________________________ Work: ______________________________Parent Cell Phone: _____________________________Email Address: ________________________________________Tuition for Limited Open Enrollment is $8,000/year and may be made in one payment to be made uponenrollment and prior to the student’s first day of attendance or in two payments, $4,000 to be made prior to thestudent’s first day of attendance each semester of the school year.I have been informed of the receiving district’s policy concerning the nonrefundable tuition fee of 4,000 per semester to be paid priorto the beginning of the semester, per year, per student. I also understand that a transfer may be denied and/or non-renewed byLovejoy ISD for, but not limited to, the following reasons as determined by Lovejoy ISD:1. Disciplinary reasons (in school-or outside school)2. Excessive tardiness or absences3. Falsification of enrollment information4. Failure to provide timely transportation after school5. Failure to meet admission criteria in Tuition-Based Limited Open Enrollment GuidelinesBy signing below, you are stating that the information provided on the application as well as the additional documents provided withthe application as required are true and accurate to the best of your knowledge. You are also agreeing that you understand thatfalsification of any information provided will result in immediate denial of your application and/or removal from Lovejoy ISD.______________________________ ________________ ________________________________Signature of Parent/Guardian Date Printed Name of Parent or Legal GuardianPLEASE SUBMIT COMPLETED APPLICATION, PAYMENT AND ALL ADDITIONAL REQUIRED DOCUMENTS TOTHE SUPERINTENDENT’S OFFICE AT 259 COUNTRY CLUB RD., ALLEN TEXAS 75002▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪For Office Use Only Central Office Approval[ ] Approved[ ] Not ApprovedCampus Assigned to: ____________________________________________________________________Superintendent or Designee___________DateQuestions regarding this process should be referred to Cindy Booker 469.742.8003 or by email tocindy_booker@lovejoyisd.net.